Resources

In recent years, major advances in both the knowledge and practice of wound care have coincided with an increase in the incidence of wounds, due in part to the ageing UK population as well as the increased prevalence of chronic disease and comorbidities, and a rise in clinical and surgical interventions (Myers, 2004).

Biatain Silicone, which is available both in normal and lite versions, is a multilayered soft silicone adhesive foam dressing which can be used on a wide range of exuding wounds for moist wound healing and exudate management.

The importance of nutricion for hostpital patients cannot be overestimated; it aids wound healing, helps reduce falls due to loss of strength/muscle mass, reduces incidences of pressure ulcers and helpds to reduce length of stay¹. However, achieving adequate nutrition in hospital can be challenging with many different obligations vying for priority on a hospital ward². In addition, certain medical conditions

Urinary incontinence is a common problem in the UK, and one often seen by community nurses. While it is often associated with ageing, urinary incontinence can in fact have a number of causes and it is important that the community nurse is aware of the full range of aetiologies and presentations. Community nurses should have a good basic understanding of the causes of incontinence, be able to provide a basic first assessment, become adept at asking the right questions and be able to offer some conventional treatment and problem-solving strategies for immediate relief of symptoms. Most importantly, they should be able to identify when a patient will need referring to a specialist practitioner for more extensive assessment and investigation. This article looks at the assessment of urinary continence in the community, and outlines the common presentations that nurses should look out for.

Stroke is a major cause of mortality and lifelong disability, despite advances in diagnosis and treatment. The risk factors of stroke are well-known and many are modifiable through lifestyle adjustments, however, the incidence of first-time stroke is increasing year-on-year. Primary stroke prevention is an important health promotion issue and successful implementation could lead to a reduction in the incidence of stroke and relieve a costly burden to the NHS. Nurses play an important role in providing information and advice to patients in secondary prevention of stroke, and could play an equal role in primary prevention. Providing advice on lifestyle behaviours such as smoking, alcohol consumption, diet and exercise all fall under the remit of the nurse in health promotion and in secondary stroke care. By providing a primary prevention service, community nurses could work as case managers for a larger multidisciplinary team and provide prevention advice and treatment.

Steve Robertson, professor of men, gender and health and co-director of the Centre for Men’s Health at Leeds Beckett University

A six-week community wellness programme was conducted to promote weight loss and reduce obesity.  Participants’ weight, blood pressure, waist circumference, body mass index, and finger-stick glucose were measured before and after the programme which included exercise, nutrition and diabetes prevention sessions. Initially, 189 men and women enrolled; 74 participants were included in the post-intervention data collection. Statistically significant results (p <0.001) indicated that women reduced weight (mean 3.31% ± 0.02%) and decreased  waist circumference by 1.91552% ± 2.14454 inches. Men reduced weight significantly (mean 6.5% ± 0.44%) and decreased waist circumference (mean 3.14063 ± 3.04118 inches) (p<.001).

Jenny Manry, DNP, FNP, APRN-BC, Assistant Professor, Fort Hays State University
Jane Peterson, PhD, APRN, FAANP, Clinical Associate Professor, University of Missouri Kansas City

Article accepted for publication: February 2013

This articles deals with the dietary advice that should be provided to people with type 2 diabetes by anyone working in the community (it does not cover advice on physical activity or prevention of type 2 diabetes). If a patient with type 2 diabetes is overweight or obese, the most important factor is to lose weight — even a 5–10% weight loss can improve insulin sensitivity and hence diabetic control. Other factors that are considered in this article are the type of carbohydrate that can be eaten, with wholegrain/high-fibre, lower glycaemic index starches being the best option (the glycaemic index measures the effect of carbohydrates on blood glucose level). Although sugar provides 'empty calories' (food that supplies energy but negligible nutrition) and can result in weight gain, it does not contribute to diabetes directly. Cholesterol levels should be reduced by eating the correct fats, and salt levels should be kept to below 6g a day.

This articles looks at the dietary advice that should be provided for people with type 1 diabetes. As well as focusing on healthy eating generally, blood sugar control can be optimised if both the type and amount of carbohydrate is considered. Low glycaemic index (GI) carbohydrates, where glucose is released slowly into the blood stream, may help to lower the individual’s glycated haemoglobin (HbA1c) levels (HbA1c is a form of haemoglobin that is measured to identify the average plasma glucose concentration over a prolonged time period). Carbohydrate (‘carb’) counting should be considered as it can improve glycaemic control and promote independence in regard to food choice and management of the condition. Gestational diabetes (that which develops during pregnancy) is also considered, as this can affect birth outcome, the baby’s future health and the health of the mother after the birth.